caregivers with close relatives in Nursing Home (NH) Pr Anne-Sophie - - PowerPoint PPT Presentation

Effect of a program for family caregivers with close relatives in Nursing Home (NH)

Pr Anne-Sophie Rigaud, Catherine Bayle, Souad Damnee University of Paris Descartes, Assistance Publique-Hôpitaux de Paris France

CONFLICT OF INTEREST DISCLOSURE

I have no potential conflict of interest to report

Caregivers with close relatives in Nursing homes (NH)

Feeling of caregivers (Givens &al 2014)

• Inadequate personal care
• Lack of communication with NH professionals
• Challenges of surrogate decision making
• Anxiety and stress

Needs for:

• Emotional support
• Education regarding prognosis
• Better communication with professionals

Promising interventions in the literature (Shultz et al, 2014)

Objectives: Help caregivers understand:

• Disease & institution caring

management

• Their own role

1 course = 7 sessions 2hours/week 10 -15 caregivers

• Neurodegenerative disease &
• utcome
• Nutrition & NH solution
• Caregivers feelings linked to

relative in NH

• Institution caring management

& resident day schedule

• Caring until death

4

• Focus groups
• Interviews

Caregivers

• Focus groups
• Interviews

Professionals in NH

Caregivers Assessment

Pre and Post with a mixed method Quantitative

• CADI: : Carers Assessment of Difficulties Index

(Nolan et al 1998)

• CASI: Carers Assessment of Satisfaction Index
• CAMI Carers Assessment of Managing Index
• Competency Feeling Questionnaires

Qualitative

• Interviews (Braun & Clarke)

Results

7 Courses

• 80 Caregivers

Mean age 67

• 76 %Women
• 5 drop-out

430 Followers 15 professionals 16 Nursing homes

Results CADI CAMI CASI

Ex CADI

7

NA for me Not stresing Stressing Very stressing 1 2 3 % ans0 > 50%  Scarce Difficulty % Σ ans 1, 2 et 3 > 50%  Occurring difficulty Σ Rep 1, 2 et 3 Moy Σ ans 123 > 2  Stessing Difficulty

CADI: Difficulties for caregivers

 Free time Financial difficulties  Pause  Holiday Health professionals not understanding Not enough help Culpability  Real relationship  Sleep Quality PRE POST

8

Program

Boost mind drinking, smoking

CASI: Care and managing strategies

Pre = Passive Accept situation Patient  responsible Live day after day Post = Involving Anticipate by planning Change one’s mind reading Search for positive Boost mind drinking & smoking Calm down swimming, walking Participate in support group

9

Program

CAMI: Caregiver Satisfaction

Give pleasure Maintain dignity Help = expression of love Find small improvements Interests & contacts

10

Give pleasure Maintain dignity Help = expression of love PRE POST

Program

Competency feeling Questionnaire

11

• Satisfied with contact with patient
• Patient does not ask more than needed
• I can leave the person alone
• I do all that I must do

Qualitative analysis

• Better understanding of:

– Nursing home caring management – Disease: Cognitive & behavioural disorders

• Improvement of:

– Communication with health professionals – Relationship with relative

• Decrease of emotional pain

Discussion

• Limits: no randomized control trial
• Advantages

– 1st program in France for caregivers with relatives in institution – Codevelopment with caregivers to meet their needs – Partnership between health and social professionals – Dissemination in Paris suburbs, Bayonne, Lyon

Thank you